Scandal of NHS and Third World nurses

Britain is systematically stripping the developing world of its nurses to shore up the NHS, despite a government ban on recruiting from the Third World.

In the five years since Nelson Mandela appealed to Britain to stop poaching nurses from South Africa, the numbers entering the country have risen more than fivefold – from 393 in 1997-98 to 2,114 in 2001-02.

Two thousand nurses are needed to run a 600-bed hospital in the UK.

Recruitment is also spiralling from other African countries, including Zimbabwe, Zambia, Kenya, Botswana and Malawi. In total, these five countries supplied 986 nurses to Britain last year, compared with 91 in 1998-99, figures from the Nursing and Midwifery Council reveal.

Ministers urged NHS trusts to stop actively recruiting in South Africa in response to Mr Mandela's appeal but did not formally ban them until 1999. The ban included Caribbean countries, and recruitment from there has since declined (although they still supplied 248 nurses in 2001-02).

Last year the Government published a code of practice extending the ban to all developing countries except where the host government had invited the UK to recruit. This included countries such as the Philippines, where there is a known surplus of nurses.

The ban did not extend to commercial recruitment agencies, which critics say are now doing the NHS's "dirty work". A spokeswoman for the Nursing and Midwifery Council said yesterday: "Our impression is that most nurses from Africa are coming through private recruitment agencies despite the Government's advice not to recruit from there."

The Department of Health said 34 recruitment agencies, listed on its website, were registered as following its code and operating ethical recruitment practices, including not recruiting from the developing world. A spokeswoman said she did not know what proportion of the total number of agencies this represented.

In a parliamentary written answer to the Liberal Democrat MP Paul Burstow earlier this month, the department said there were 92 agencies in all – meaning two out of three had not signed the code of conduct.

Evan Harris, the Liberal Democrat health spokesman, said yesterday: "It's disgusting and it was predictable that reliance on overseas recruitment would pull in the precious trained staff from other countries. It is morally indefensible to allow this to happen without admitting it, quantifying it and offering some reciprocation. The Government has decided that the priority is to increase the capacity of the NHS no matter what the cost. And it is the populations of these poor countries that are suffering."

The Department of Health spokeswoman said NHS trusts were "encouraged" to use only those agencies that followed the code of practice, but they could not be ordered to do so because of the Government's policy of devolving decisions.

She said: "We are committed to the ethical recruitment of staff from abroad. The NHS does not actively recruit nurses from developing countries or through recruitment agencies."

Several nurses had arrived through word of mouth or by learning of job opportunities on the internet. "We can't prevent people coming to this country and getting a work permit if they want to," she said.

Some countries have a surfeit of nurses. The department currently has agreements with India, Spain and the Philippines allowing the NHS to recruit. The Philippines, known to NHS trusts as a "nurse factory", trains nurses to go abroad so that they can remit their earnings back to their families at home, boosting the country's economy.

Last year it was Britain's single biggest source of nurses, supplying 7,235, compared with 52 in 1998-99.

South Africa is the second biggest source of overseas nurses, followed by Australia and India.